The Secretary of State for Health and Social Care (Matt Hancock)
I beg to move,
That this house has considered covid-19.
The House meets today to debate the coronavirus pandemic once more. The peril of the pandemic has no short-term quick fix, but calls for ingenuity, commitment and resolve from us all. We have responded with one of the greatest collective efforts that this nation has seen in peacetime, but the fight is not over: the virus continues to spread, and cases, hospitalisations and, tragically, deaths are all rising. Yesterday we learned that Liverpool University Hospitals NHS Foundation Trust is now treating more patients than it was at the peak in April, and across the UK the number of deaths has doubled in under a fortnight. And yet, just as the situation we face is grave, so the hope of a solution is growing. With every day, my confidence in the ingenuity of science to bring resolution grows. But until that moment, we must have resolve. We are focused on finding a long-term solution, and we reject political point scoring. I call on the House to work together in the interests of our whole nation—and, indeed, the whole world.
Chris Bryant (Rhondda) (Lab)
I just wonder whether one problem we have at the moment is that we do not have enough capacity in the whole of the NHS to take on covid in a long-term way, as the Secretary of State suggests, and still be able to do all the things that we really need to do. How can we ramp up that capacity so that we are still treating people for cancer, for brain injury and for all the other things that we all care about?
Matt Hancock
The hon. Gentleman is absolutely right. He represents a seat in Wales, and this is a challenge for the NHS in all four nations of the United Kingdom. I was going to come on to this, but one thing that we have learned in the first phase is how we can do better in keeping the other services running that the NHS must and should provide, for instance for brain injuries, for cancer treatment and for heart patients. There are also those things that are not life-threatening, but that harm people’s lives—a painful hip or a cataract that needs treatment. In the first wave, as we knew so much less about this virus, many of those treatments were stopped altogether.
In the second wave, we have two things at our advantage. The first is that this is a much more regional second wave, which puts more pressure on areas such as Liverpool and Lancashire than elsewhere in the country, but that does mean that elsewhere the elective and the urgent operations can continue. The second difference is that we know much more about the virus and how it spreads, so we have separated the NHS into green sites and blues sites. Green sites are for where we have a high degree of confidence that there is no covid, using testing and asking people to isolate before going in for an operation, so that people can have more confidence. The central message across all parts of the UK is that the NHS remains open. Finally on this point, the best way we can keep the sorts of treatments that we all want to see going is to keep the virus under control.
Mark Tami (Alyn and Deeside) (Lab)
The Secretary of State has answered my question in part with the importance of green and red. One of the big problems in the first wave is that people were frightened, even if they feared that they had cancer or some other condition, to go into the hospitals, and we have to reassure them that they can go there and they can be safe.
Matt Hancock
The right hon. Gentleman is absolutely right. We have an advertising campaign, “Help us to help you”, to make the simple point to people that, if they are asked to go to hospital by a clinician, then it is safer to go to hospital than not to do so. In fact, we call them green sites and blue sites. Green means free from covid—we are as confident as we can be that they are. It is blue, not red, which means that we still want people to come to hospital, even if they have to come to A&E, because there is only likely to be, at worst, as much covid as in the general population, unless, of course, a person is in a covid ward treating only covid patients. The NHS has learned a huge amount both about the microbiology of the disease and about how to run health services in a world when covid is at large.
Mr Steve Baker (Wycombe) (Con)
Of course this is a dangerous disease and, of course, cases are rising, including in my own area, so it is with some humility that I have a look at the daily excess all-cause deaths in all ages in England, which show that there has been no significant excess all-cause mortality observed in week 40 overall. Is it not the case that the good news in this second wave is that the disease is not progressing as it did in the first?
Matt Hancock
I want to keep it that way. It is true that the all-cause mortality rates are around the typical levels for this time of year, and that is partly because non-covid deaths are actually lower at the moment than in most years, and because, thus far, we have worked to keep this virus under control. We know from the basic mathematics of compounding growth and the exponential nature of the growth of any virus that the number of deaths will increase if the number of cases increase exponentially, hence the need for the actions that we in this House have voted for.
Bob Stewart (Beckenham) (Con)
On that point, many of my constituents were frightened to go to hospital because they thought that they might get infected with covid. With that in mind—I am quite sure my right hon. Friend has thought of this—would it not be an idea to separate out hospitals, so that we have a covid centre of excellence, say using the Nightingale hospitals, where everyone goes, and then the normal hospitals that deal with everything else? Forgive me for raising this point, because I am quite sure that the Secretary of State has a very good answer.
Matt Hancock
It is a brilliant idea—so brilliant that the NHS has spent the summer working on that concept. We cannot do it as perfectly as my hon. Friend suggests, and the reason is the practicalities of the treatment of covid—for instance, if someone has covid and something else, they need a normal intensive care unit. But the Nightingale hospitals are there—in fact today, sadly, the Nightingale hospital in Manchester is reopening. For all the rest of the hospitals, we are making sure that different parts of the hospital are deemed either blue or green—essentially covid-free or at risk of covid. Some of the different buildings are covid-free or non-covid, or, in some cases, whole hospitals are covid green sites and people cannot go to them unless they have tested negative. That means we can have a high degree of confidence because, for instance, if we are treating cancer patients, we want to ensure that there is not any covid in there.
We need these long-term solutions and, like other liberal democracies around the world, we are wrestling with this question—as we have wrestled with it in the last few minutes—of how to keep people safe from the virus while protecting other important things in life: our liberties, our livelihoods and the things that we love. That is what leads us to the strategy of suppressing the virus and supporting the economy, education and the NHS. The NHS needs to be supported to do all the other things that it needs to do until a vaccine is available.
I reject the false choice that says we must pick a side and choose between a healthy economy and a healthy nation, because the two are intrinsically linked. If, God forbid, we were to let the virus unleash its full force, the damage to not just the NHS and the hundreds of thousands of lives, but our livelihoods would be catastrophic. We can only get our economy and our society going gangbusters again if we drive this virus down, so that people have the confidence that they need to live their lives to the full—and drive it down we must.
This is a deadly virus, and, yes, it reserves its biggest impact for the oldest in society, which means the rise in the number of cases among the over-60s gives me a lot of cause for concern. We also just heard compellingly from the Minister for Equalities about the impact on people from ethnic minority backgrounds, but the impact is not confined to these groups. The virus can affect anyone of any age and any background, and we have already seen worrying numbers of young, fit, healthy people suffering debilitating symptoms months after contracting covid. Yesterday, a study by King’s College London showed that one in 20 people with coronavirus is likely to have virus symptoms, such as fatigue, breathlessness, muscle pain and neurological problems, for eight weeks or more. Yesterday, I visited the cutting-edge long covid clinic at University College London hospital. I have met people in their 20s and 30s unable to work, sapped of all their energy, living with the long-term effects of a virus that has completely changed their lives. Therefore, to anyone of any age, catching covid can be very grave indeed. Long covid underpins, again, our strategy for suppressing the virus until a vaccine arrives.
Dr Luke Evans (Bosworth) (Con)
When my right hon. Friend came to the Health and Social Care Committee a few weeks ago, he talked about long covid and the fact that clinics were being set up to deal with it. Will he give the House an update on where that has got to?
Matt Hancock
These clinics are being set up—the London clinic is now open—but we need to see them right across the country. The NHS now has a programme of rolling out clinics to be able to support people and, of course to communicate with GPs. That is important because primary care is often where people arrive with long covid, because there appears to be no correlation between the seriousness of someone’s initial illness and how long they can have these debilitating consequences. In some cases, people have no symptoms of the coronavirus initially, but then find that they have months and months of fatigue, a brain fog and muscle pain, and they do not know where it came from until they are diagnosed with long covid. It is a very serious complication.
John Spellar (Warley) (Lab)
To enable us to get a picture, could the Secretary of State tell us what percentage of people up to 25 suffer from the condition?
Matt Hancock
Yes. We have two points of evidence; one is the evidence from King’s College London that shows that approximately one in 20 people with coronavirus is likely to have long-term symptoms, but the other evidence implies that in adults under 50, the proportion is more like one in 10. There seems to be some correlation that implies that it is more of a problem among younger people, but the understanding of long covid is still in its early stages and an awful lot more research is needed.
John Spellar
I am sorry to press the point, but it is a question of roughly what percentage is affected; not of those who contract the disease, but of the overall cohort.
Matt Hancock
It is very difficult to know. We estimate that approximately 8% of the population have had covid and that one in 20 people who has had it has symptoms for longer than eight weeks. Of course, the fewer people who get covid, the fewer people who get long covid, which reinforces the overall strategy of suppressing the virus until we get a vaccine. Let me turn to how we do that.
We cannot reiterate enough the importance of the basics: social distancing and “hands, face, space”. The next area is following rules on local action, which are at the core of how we and an increasing number of other countries around the world are tackling the crisis at the moment. Through our local covid alert levels, we have been able to take a balanced approach; I would like to update the House today on some further changes that we are making.
Unfortunately, we are seeing rising rates of infection in Stoke-on-Trent, in Coventry and in Slough. In all those areas, there are more than 100 positive cases per 100,000 people, cases are doubling approximately every fortnight and we are seeing a concerning increase in cases among the over-60s. We have agreed, in partnership with local leaders, to move those areas into the high local alert level, which will come into force at one minute past midnight on Saturday.
The central change is that people will not be able to meet other households socially indoors. This applies in any setting—at home, in a restaurant or in any other venue. The rule of six still applies in any outdoor setting, and although people may continue to travel to open venues, they should reduce the number of journeys where possible. I thank local leaders in the areas for the work they have done and for their co-operation. I can assure the people of Stoke-on-Trent, of Coventry and of Slough that we will support them all the way through, including with the business support that the Chancellor announced earlier today for all areas with a high local alert level.
We are also formally beginning discussions with Warrington about moving into the very high alert level, owing to a continuing rise in cases there.
Andy Carter (Warrington South) (Con)
I thank the Secretary of State for the ongoing dialogue with me as a Warrington MP and with my colleagues in Warrington. I was particularly concerned this morning after having seen Public Health England data about the rapid rise in the infection rate among the over-60s in Warrington. Could he say a little more about that information?
Matt Hancock
I am worried about the rise in cases, especially among the over-60s in Warrington. We have seen that case rate continuing to rise, despite the hard work of people locally, since Warrington was moved into local alert level 2. There is an excellent local hospital in Warrington, but it is dealing with a very high number of cases and is working with other local hospitals to ensure that everybody gets the treatment they need. I pay tribute to my hon. Friend, who has provided great leadership in his local community. I hope that with everybody supporting these measures and taking the actions necessary, we can keep these restrictions in place for as little time as possible, but I am absolutely convinced that we need to make progress. I have announced today that we will formally start the talks; I hope that we can reach an agreement and resolution soon.
The virus moves quickly, so we must respond quickly and in a targeted way like this to keep it under control. As part of local discussions, local authorities including the Local Government Association have asked for stronger enforcement powers, and I agree. To support businesses who are doing the right thing it is fair that we take action against those business who are doing the wrong thing. Firm enforcement helps make these restrictions fairer for all. We want to put in place stronger regulations to give local authorities further powers to take further action in their area. The proposals that we will bring forward will mean that councils will be able to act without delay and use closure notices to shut premises on public health grounds to help suppress the virus. We will work with local authorities in the coming days on the details of these proposals so that we can act in a firm and fast way against the minority who are breaching these life-saving rules.
These changes will help us fight the virus in the here and now but we are also making progress on long-term solutions. The long-term solution is not to give up, as some would have us do, or wish the virus away; it is to harness the science and the ingenuity of innovation while supporting people through.
First, on testing, thanks to exceptional work from so many people we have built a critical national infrastructure of diagnostic testing. Today’s testing capacity is now over 370,000. Alongside this expansion of the current technology, I want to update the House on mass testing. I know there have been many questions about this project. Last week, we began rolling out new testing technologies to hospitals based on the point-of-care LAMP—loop-mediated isothermal amplification—test. That will allow the regular repeat testing of NHS staff and patients. I am delighted to be able to tell the House that yesterday we began the roll-out of lateral flow tests to schools and universities. Lateral flow tests do not require a lab or a machine; the kit gives a result within minutes. We have successfully purchased many millions of these tests and they will allow us both to find the virus where it spreads and to reduce the disruption that virus control measures inevitably create.
If we can deliver a mass-testing solution so that pupils in a bubble do not have to isolate for a fortnight when one in the bubble tests positive, we will not only help control the spread of the virus but we will protect education better and help schools, teachers and parents to live their lives much closer to normal. These tests will also allow directors of public health to have more rapid access to testing capacity and we are starting the roll-out to councils, including today with the council in Stoke-on-Trent.
The second area to touch on is vaccines. Progress continues on the development and the deployment of vaccines, and we are determined to give those developing vaccines all the support they need. I can inform the House that we are initiating human challenge trials to speed up the development of the coronavirus vaccine and to improve further its safety. We are contributing £33 million to back these trials, joining forces with academia and industry. A human challenge trial involves taking a vaccine candidate that has been proven to be safe in trials and giving it to a small number of carefully selected, healthy adult volunteers who are then exposed to the virus in a safe and controlled environment closely monitored by medics and scientists. That gives us the chance to accelerate the understanding of promising vaccines that have been through the clinical trials so that we can improve on their safe development. The UK is one of the only countries in the world with the capability to run that kind of programme, and we should all be proud that, once again, we are leading on this global effort.
Our response to this lethal virus has been one of the greatest collective endeavours that this nation has seen. Thanks to those efforts, we are better prepared this time round. As a nation, we built the Nightingale hospitals in just nine days. As a nation, we came together as one to protect the NHS, and it was not overwhelmed. Now the NHS is better prepared still. As a nation, we built the biggest testing capability of all our peers, and we have made huge and historic advances in vaccines and treatments. We understand this virus infinitely more than at the start of this pandemic but we are not there yet—not when the virus is spreading at pace. So we must each of us look at what we can do, the role we can play and what actions we can take. We have seen throughout this pandemic that we are at our best when we come together. We know that with science on our side ultimately we will prevail.
Several hon. Members rose—
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Given the numbers who are interested in the debate and given that I have enjoyed the indulgence of the House now for four days in a row—I am not sure what I will do next week; I might just come here and make a speech for the sake of it—I will try to be brief. I also apologise to the House, because I have a long-standing commitment and so I will not be here for the wind-ups. I apologise to the House for that discourtesy on this occasion. I have spoken to Mr Speaker about it, and he understands the particular circumstances.
I noticed that the Secretary of State has updated the House on Slough, Stoke-on-Trent and Coventry, but he did not mention anything about Nottinghamshire and West Yorkshire, and he will know that they are candidates that are widely speculated as the next to go into the tier 3 lockdown restrictions. For example, in parts of Nottinghamshire, localised infection rates are 370 per 100,000 in Gedling and 362 per 100,000 in Rushcliffe. In West Yorkshire, the rate is 307 per 100,000 in Wakefield and in Calderdale. Given that, he must be considering the future of West Yorkshire and Nottinghamshire.
I am just aware that we are going into the parliamentary recess. I do not know whether I can invite the Secretary of State to say anything now, because Members from those areas will be concerned that with Parliament not sitting next week, they might not have an opportunity to put their points to him or get their points on the record. If he does not want to say anything now, it would be important if the Minister of State could offer some reassurance to people in those parts of the world as to what might be happening.
Matt Hancock
As previously announced, discussions are under way. We want to proceed in consultation with and working with the local areas. With the parliamentary recess next week, we will find a way to ensure that colleagues are appraised of the situation, preferably in advance of any announcement.
Jonathan Ashworth
I am truly grateful for that reassurance, because the Secretary of State will understand that many people in those areas will be concerned and Members will want to get their points of view on the record on that front.
The virus has caused a pandemic because it exploits ambivalence and takes advantage of our human vulnerabilities. It undermines our biological defences and spreads through human social behaviour and clustering. We know that people with long-term chronic conditions in particular are vulnerable, and we know that there is a greater burden of illness in our more disadvantaged areas, which covid cruelly exaggerates. We know that as we entered this crisis, we had less resilience as a society. We entered with life expectancy falling for some of the poorest and stalling nationwide, and life expectancy is a summary of our overall health.
In the past 10 years, the amount of life in good health has decreased for men and women. Our child mortality rates are some of the worst in Europe, and poor health and chronic illness leave communities acutely vulnerable to disease, so it should come as no surprise to any of us that some of the boroughs currently fighting the most virulent fires are some of the very poorest in our country, with the very worst life expectancy.
I welcome the progress being made on diagnostics, therapeutics and vaccinations, which the Secretary of State has updated us on today. We welcome the expanding of mass testing, including the saliva testing and the lateral flow testing. I hope, by the way, that the Secretary of State will invest in our great universities, which are developing some of this saliva-based testing, because they will need the equipment and the labs to process it. He will probably need to invest in robotics and artificial intelligence to do some of that, because there are not enough staff to do it at the moment, and I hope that is part of his agenda. As well as all that, because the virus is now endemic, we will need a health inequalities strategy to get on top of this virus for the long term.
In the immediate term, we also need to adjust our behaviours to bring infection rates down, which is why I have supported the difficult restrictions that the Secretary of State has had to impose, and it is why we are saying we need clarity all the time from Government. But people also want to know that there is light at the end of the tunnel, because it is still not clear to families in Bury, Heywood and Penistone and all those other places that have been put under lockdown in recent days how they will escape it.
We still do not know whether the restrictions across the north will be lifted when the national R falls below 1 or when local regionalised R values fall below 1. We still do not know whether restrictions will be lifted across the north when hospital admissions stabilise. Yesterday, the Prime Minister said that decisions are
“based on a number of things including the R—also, of course, rates of infection, rates of admission to hospital and other data.”—[Official Report, 21 October 2020; Vol. 682, c. 1053.]
He did not tell us what that other data is. Perhaps the Minister responding to the debate can outline how an area in the north in tier 3 gets out of those restrictions. I know that the areas will be reviewed every four weeks, but what are the criteria to inform those reviews?
I represent Leicester, where we are in tier 2, but we have been in a version of restrictions for 114 days. We went directly from national lockdown to local lockdown. In fact, we endured tougher restrictions than those currently designated for tier 3. Our hospitality closed, our non-essential retail closed and—I did not agree with this—our schools closed as well. All those measures together did help to bring infections down in Leicester to about 55 per 100,000—to be frank, many Members would bite your hand off for 55 per 100,000 now—and even at 55 per 100,000 we remained in a version of lockdown.
Now, months later, after all the sacrifice we took in Leicester—after months with our businesses closed, with the mental health impact of people not being able to see their loved ones and families denied the opportunity to visit a care home to see their grandmother or mother—our infection rates in Leicester are 219 per 100,000. The Secretary of State will therefore have to forgive me when I express some scepticism that his approach will work and suppress the virus to the levels sufficient to bring the R value down, because although the early restrictions in Leicester did have an impact, after months we are still under restrictions with infection rates over 200 per 100,000.
The Secretary of State updated us on the situation we are in. He has been good at updating the House repeatedly; I have no criticism of him at all on that front. The growth rate in the virus is slower than in March—it is more muted, thanks to the great sacrifices of the British people, with hand hygiene, social distancing and everything we are doing—but it is not plateauing. We are dealing with an autumn resurgence, and for all the heat and fallout we have had across the House this week, the truth is that the virus is at worrying levels everywhere. The national R is between 1.3 and 1.5. The R across the south-east is between 1.3 and 1.5, across the south-west between 1.3 and 1.6, and across the east of England between 1.3 and 1.5.
Of course, admissions to critical care are currently concentrated in the north and the midlands, but while at this stage in the first wave those admissions to critical care were beginning to come down, they are continuing to go up. It is right that improvements in care mean that people are less likely to die. That is a good thing, and we all celebrate that, but general and acute beds are filling up with covid patients across the north and across the midlands.
We know that the Prime Minister has rejected a circuit break for now—he does not rule it out indefinitely. We think he should have taken advantage of next week’s half term. He decided not to do that. But we should remind ourselves that SAGE advised the circuit break on 21 September. A month later, on 21 October, we had these grim statistics: 191 deaths; 996 hospital admissions; 6,431 in hospital; 629 on ventilation; 26,688 tested positive; and 249,978 cases in the past 14 days. Many will ask how much of that could have been avoided, had the Prime Minister gone along with SAGE’s advice a month ago.
Today, the Chancellor said in his statement that we have to find a balance between saving lives and protecting livelihoods, but I do not believe that the two are in conflict. It is not a trade-off. Actually, I do not believe the Secretary of State thinks it is a trade off—the tone of his remarks was very different from that of the Chancellor earlier. Saving lives and protecting livelihoods go hand in hand. I worry that the approach the Government are currently taking—while understandable, because nobody wants to be in a lockdown, and none of these decisions are easy or do not have negative consequences; I think we are all mature enough across the House to appreciate and understand that—means that there will, by necessity, have to be tougher, deeper action in the weeks to come, not only in autumn. Winter has not hit us yet.
Professor John Edmunds of the London School of Hygiene said yesterday in one of the Select Committees that
“there’s no way we come out of this wave now without counting our deaths in the tens of thousands…I think we are looking at quite a bleak situation unless we take action…I don’t think we should be taking action just specifically in the highest risk areas, but I think we need to take action everywhere”.
A similar sentiment was expressed by Sir Jeremy Farrar, who is also on SAGE. For balance, Professor Van-Tam said at the press conference this week that he disagreed, but also that
“we may have to push on the pedal a little harder”
to get it under control.
I know the Secretary of State is a decent man. He has been very good throughout this crisis in talking to me privately; one would expect a Secretary of State and a shadow Secretary of State to have those discussions. Whenever I have asked for briefings, all the way back to January, he has ensured that the chief medical officer would give me confidential briefings, as I am sure that every Member across the House would understand and appreciate. So I know he is a decent man. I know he is not playing games or anything like that. I know that these are difficult judgment calls of extraordinary gravity. I know there is no easy solution. Everything has trade-offs; everything has negative consequences. But we also know that unless we take decisive action, the consequences could be even worse. No one should pretend to the House that that is not the case. There is a worry that by not taking action now, we will, in the words of Professor David Hunter, an epidemiologist at Oxford,
“all wind up in tier 3 eventually.”
According to Times Radio yesterday, Government sources were telling it that the Government are now planning a three-week circuit break next month across all tier 2 and tier 3 areas. If that is the case, then the Government should probably level with us so that we can all start preparing for it.
This is not just about minimising harm and deaths from covid. As the Secretary of State said in responding to questions from my hon. Friends, we have a huge responsibility and duty to minimise harm and deaths from non-covid conditions as well. We have to avoid the situation that we were in in the spring, when the immense lockdown, which was actually a number of different interventions all at once, meant that to build surge capacity in the national health service, we had to cancel elective operations to free up general and acute beds, and much important diagnostics work and treatment got delayed. That has left us with a situation today where 110,000 people are waiting beyond 12 months for treatment, compared with just 1,600 in January; 3 million people are waiting for breast, bowel or cervical screening, and more people are waiting for treatment.
My worry is that we will end up building a greater backlog in treatment if we do not act. General and acute beds are filling up. We have a number of hospitals cancelling electives already. Bradford has just suspended non-urgent surgery. Birmingham is talking about suspending non-urgent surgery. It is happening in Nottingham. We know that Merseyside is under considerable pressure; the Secretary of State outlined it. It has just been revealed in the Health Service Journal that we are heading into this winter with 2,000 fewer beds than we had last winter. Today the Royal College of Emergency Medicine has warned that over half of A&Es across the country are caring for patients in corridors due to the lack of beds—and we are not even in winter yet. Our overcrowded A&Es are not ideal at the best of times, but during a covid pandemic it is obviously highly dangerous to be treating patients in corridors of A&Es. The president of the royal college, Katherine Henderson, has pointed out that this situation
“will put more lives at risk than it ever did before.”
If the Government really want to drive down infections, suppress the virus and ensure that general and acute beds are not overwhelmed and more operations are not cancelled, then they have to seriously consider what steps they need to take to go further. Unless the Secretary of State or the Minister is going to get up at the end of this debate and say, “Actually, we’re going to do a circuit breaker over half-term next week”, I accept that the Government have probably missed that window of opportunity now, but at some point they will have to take further action.
We could have avoided much of this if test and trace had been more effective. The Secretary of State is spending £12 billion on this programme. Twelve billion pounds is a colossal amount of money. Some of it is going on consultants who earn £7,000 a day, but where on earth is the rest going? We are throwing around figures in this covid debate, and we are becoming quite complacent and relaxed about them, but £12 billion is an extraordinary amount of money; we could probably run the NHS for a month or so on that. We learn today that the system is contacting only 59.6% of contacts, which is the equivalent of failing to contact 101,000 people. That is not world beating; it is a world-beating shambles. I really hope that the Government look at stripping all the failing private outsourcing firms, such as Serco, of these contracts and putting local public health teams in charge. That would be much more effective.
Jonathan Ashworth
Absolutely. There have been problems with the app. When I am in Leicester, it tells me that I am in an area that is both medium and high alert. Leicester has been under lockdown for 100 days, so how can the app say that in the part of Leicester where I live?
Matt Hancock
I thought that the hon. Gentleman’s comments were very thoughtful until we got to the unnecessary political knockabout. I want to make a couple of factual points about the app. It only takes the first two segments of someone’s postcode, some of which spread over two different alert levels, so that is why it describes the situation in Leicester as it does. When it comes to making sure that people press the button on the app to access the £500 self-isolation payment for the low-paid, that button is there on the app.
I want to leap to the defence of Test and Trace, because in the past fortnight the number of contacts and cases that have been reached has doubled. In slightly more than the last month, the distance travelled to get a test has halved, and the turnaround time for tests that are sent to care homes—those tests are critical for saving lives—has come down. More than 50 statistics on Test and Trace are published every Thursday, and of course the hon. Gentleman can look through them, find a couple that are going in the wrong direction and complain about them, but I think it is better to have a balanced opinion.
Jonathan Ashworth
That was a spirited defence, but the statistics have been bad every week. The Secretary of State knows that, because I have raised it with him every week.
Matt Hancock
What happens is that every week, the hon. Gentleman looks through the 50 statistics and finds the ones that are not going in the right direction. I am merely pointing out that the system is doing much more than it ever has. One place where the huge amounts of money that we are putting into Test and Trace go is into the record amount of testing capacity, which is now more than 370,000. I think he should stand up and thank all the people who are delivering on this colossal effort.
Jonathan Ashworth
I am very happy to thank the people who are working in Test and Trace.
Jonathan Ashworth
That is not a U-turn. Thanking the staff is not a U-turn. The Opposition are on the side of the workers; the Secretary of State is on the side of the bosses. Of course we are happy to thank the staff who are working on Test and Trace, but he cannot seriously look at the statistics and tell us that the system is effective. The Chancellor of the Duchy of Lancaster did not defend it. When he was asked about the statistics on “The Andrew Marr Show” on Sunday, he said that
“any test and trace system of whatever kind has less utility”
when the virus is accelerating. If the Secretary of State thinks that there is a good set of statistics, perhaps he should send it to the Chancellor of the Duchy of Lancaster, who took a different line on Sunday.
Let me come to a conclusion, because I know that many people want to speak in this debate. [Interruption.] The Secretary of State tells me to leave out the knockabout, but he is the one who started it off. The problem is that we went into this pandemic with an underfunded NHS, public health cut back and less resilience as a society. This will not be the only pandemic that we have to deal with. Climate change, urbanisation and deforestation mean that we are likely to see more viruses jump from animals to humans. The big challenge for us as a society when we come through this pandemic, as we will, is that we have to start building the health security to protect us for the future, because unfortunately, all of us across the House will be dealing with more of these pandemics in the years to come.
Anne McLaughlin
I see that the Health Secretary agrees with me somewhat. Everybody on these islands is tired at the moment, but those making the tough decisions do not have the option to give in to the tiredness. I might not always agree with everything they are doing—I do not generally agree with most of what they do—but I understand that everybody is an expert these days.
Some of what the Government did in response to the pandemic was good. Furloughing was not just good; it was fantastic. I am not going to qualify that. These islands were not alone in having the idea, but it was a great idea. When I sat and watched the Chancellor’s initial response, I thought he was fast, flexible and responsive. I felt at that point that ideology had gone, that politics had been taken out of the situation and that the Government were simply doing what they could to support people as best they could. In fact, I remember thinking that when the Chancellor appeared on “Spitting Image” he would be wrapped in the red flag, so socialist were some of the furloughing policies.
We also heard about people slipping through the net. As everybody keeps saying, we are in unprecedented times. We had those Paymaster General calls every day, and much of what we reported was acted on initially. It was a terrible time, but it was a good time for politicians to work together in the interests of the four countries of these islands.
Not everything was acted on, however, and not everyone was supported. Some of those gaps were never filled. I want to mention two things in particular. First, my constituency has many wholesalers who chose not to furlough their staff because they wanted to play their part in responding to the pandemic. They wanted to ensure the flow of food and drink, particularly to hospitals. I know something was said in the statement earlier today, which I have not yet seen, but they have felt for a long time that they did not receive a response.
I wrote to the Chancellor to ask about that and I just want to say something about the responses I have been getting. The hon. Member for Blaenau Gwent (Nick Smith) made a point of order about this earlier. Some of the responses have no reference—when we put a reference, they do not include it when responding. One of the complaints made in the point of order was about a six-word response to a question. I got an eight-page response to something, but I have no idea what the question was because, as I said, it did not give a reference. In addition, it seemed to be eight pages of “Isn’t the Government great?” which is just not acceptable. I do not know why the replies are like this. I wonder if it is an attempt to stop us asking questions in the first place, because I am certainly giving up sometimes.
The people who have formed the campaign organisation ExcludedUK have not given up. I am part of the all-party parliamentary group on the ExcludedUK. They have been incredible, but they are in a really difficult position and I, too, would have been in their position had I not won my seat in December. I was self-employed but I had not been self-employed for long enough. I will not go into the details, but I know that if I were one of them right now, I would not be living in the home that I have lived in for 10 years. I do not know what would have happened to me, so I identify with them and want to keep supporting them.
It was really good that the Government added £1,000 a year to universal credit, although it had been cut to the extent that that simply brought it back up to 2011 levels. On the other hand, I did not expect a Conservative Government to do that, so I am glad that they did. However, they need to extend it and they need to add it to legacy benefits. I implore them to do that and to extend the furlough scheme. Whenever that is mentioned in this place, Government Members shout, “For how long can we do that? We can’t sustain it forever!” But it would not be forever, and even though we do not know exactly how long it would last, we can estimate and reasonably suppose that by next summer there will be some kind of normality, so why not extend it until then, if needs be? In the past few months, I have noticed some terrible situations with employers and I have many examples. I already gave some examples when I spoke in the debate on whistleblowers a while back, but I want to raise one situation today, because I am hoping that Government Members will do something about it. It is a very serious matter. The employer is the Government. Whoever took the decision that I am going to tell the House about should be ashamed of themselves.
There are three service centres in Glasgow for the DWP and the situation concerns people working in those service centres who do not have to do face-to-face. I am telling the House what is happening in Glasgow, but I am sure this will not just be the case in Glasgow; I imagine that it is widespread across these islands. Workers were on a work-from-home pilot scheme. Some teams were allowed to work four days a week at home and one day in the office. Others worked three weeks at home and one week in the office.
On 23 September, the Prime Minister and the First Minister both gave the instruction that anybody who could work from home should work from home. Naturally, those workers expected that they would be allowed to work from home full time, but they were refused permission to do that. Some of the workers, who are all kitted out at home, are having to bring their equipment into the office on that one day of the week or that one week of the month, despite what the Government were saying people should do. They were constantly being told that it was fine, it was safe and that there was no danger to them. Well, that was not what the Government were saying.
On the week ending 9 October, it was announced that two members of staff in that building had tested positive. On 12 October, another three members of staff were reported to have tested positive. On 15 October, a further two members of staff tested positive—seven cases in less than a week. On 19 October, Monday of this week, there was another case and on 20 October, Tuesday, there were another two. So that is 10.
I am sure that Members can understand the fears that those workers were experiencing, but I will tell them who did not understand—or maybe they did and just did not care. Last Friday, a senior manager at the DWP held a Skype meeting with the teams to reassure them that the office was safe and to remind them that the pilot could not be changed and there could be no flexibility, despite what the Prime Minister and the First Minister were telling employers to do. I understand that the tone was more threatening than reassuring. The senior manager warned that if workers continued to raise concerns the pilot might be cancelled and they would all be forced to work in the office full time. She “hoped” that that would not have to happen. That is workplace bullying and I hope the Secretary of State will raise it with the Secretary of State for Work and Pensions. I certainly will be raising it.
Yesterday, just to bring everyone up to date, staff were told that the pilot had been suspended. That is good in the short term, because all those who can work from home are now doing so full time, but there is no information and no answer to their questions about how this situation will progress. Given threats that speaking out might mean that the pilot is cancelled and everyone will be forced to work in the office, one can be forgiven for thinking that that is what is going to happen. So I just want to ask a few questions. Why, if they could work from home and are equipped to work from home, were they forced to work in the office? Of the 10 testing positive so far, how many were part of the work-from-home pilot? How can a Government agency be given permission to ignore the restrictions that everyone else is rightly following? Will management punish the “unruly dissenters” who complained about it by forcing them all to work in the office, as was suggested by the senior manager? Do the Government understand the message that the workers are getting, which is, “You don’t matter, you have no power”?
Well, not only do they have no power, but their MP seems to have no influence. My attempts to represent my constituents started on 4 October, when I had a meeting with DWP senior managers. I had just been made aware of the situation—the meeting was about something else—so I said I urgently needed to know who to contact to raise the issue on behalf of the employees. They got back to me yesterday, 21 October, after being prompted three times. I waited 17 days and their response was, “You might need to give us some more information.” If I cannot represent those employees as an MP and make any difference to their lives, and they cannot as workers, who else can?
Madam Deputy Speaker, you are looking at me like you want me to stop—[Interruption.] No? Oh, that’s excellent.
The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)
As my right hon. Friend the Secretary of State and others have made clear during this debate, although so much has been done to get this virus under control, the fight is not over. I thank all the Members who have spoken in this debate. It is clear that this pandemic has had a huge effect on everyone’s constituents, across the country. I wish to start by paying tribute to all the hard work of NHS workers, social care staff and volunteers throughout the pandemic. I also pay tribute to the British public for the sacrifices they have made to help us combat coronavirus and for observing the essential social distancing measures that have kept us all safe. Thanks to that hard work, we are able to protect the NHS, just as it is always there to protect us. As my right hon. Friend said, this has been an incredible national effort, and we are seeing the increasing effects of it today in the compliance with social distancing, particularly among young people, which is helping us very much to slow down the progression of the virus.
I wish briefly to outline to the House a few further areas to those set out by the Secretary of State where we have strengthened our response. I will go through these quickly because I want to answer some of the points raised today. We know that we have delivered more than 4.2 billion items of PPE since last February, and our adult social care winter plan, published in September, sets out the actions for the Government and every local care provider.
I want to get straight on to some of the points that have been raised, because some really important issues have been discussed today. I cannot mention everybody and every point, but some people will definitely be receiving a letter from me, particularly the hon. Member for Twickenham (Munira Wilson). I will write to you and answer your points, because you are always very constructive in the way you ask for information and I will make sure you get that information. The hon. Member for Rhondda (Chris Bryant) made the best speech I have ever heard you make in this House—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I am going to stop the Minister. I let her do it once; she called the hon. Member for Twickenham “you” and now she is calling the hon. Member for Rhondda “you”. Please call him “the hon. Gentleman”.
Ms Dorries
I do apologise, Madam Deputy Speaker, it is because I have not been here very often lately.
The hon. Gentleman made one of the best speeches I have heard him make in this House, probably because he agreed with every word I have been saying—indeed, I almost ripped up this speech. I applaud him for some of the comments he made.
Ms Dorries
Possibly; the hon. Gentleman is in a very difficult position now. I say well done to him for taking apart the Great Barrington declaration. I will now not go into it, as he did an excellent job.
Turning to herd immunity, without a vaccine how do we attain herd immunity? With no knowledge of immunity from coronavirus, how do we obtain herd immunity? I will share with the House that I was diagnosed with coronavirus on 7 March, I had a severe dose and my antibodies had disappeared 12 weeks later. I am no longer immune to coronavirus. That is not just my story; it is the story of many, many people. Many people who were donating their plasma post-coronavirus for convalescent therapy were told quite quickly, “We no longer need your plasma because you do not have any antibodies left.” Work is going on into immunity, and we have not reached a conclusive position yet, but I can speak from my own experience and from the experiences that we are hearing about, and if people do not have long-term antibodies and we have no vaccine, there is no such thing as herd immunity. I say that again because it is the truth.
On the comments about the measures we are putting in place, how restrictive they are and social distancing, all I can say—and this relates to the number of deaths in hospitals—is that back in March no one was wearing face coverings and no social distancing was being complied with by the public, and the rate of infection was doubling every three to four days. Now, it is doubling every seven to 14 days, because the public are wearing masks, they are hand washing and they are socially distancing, and that means that when someone contracts coronavirus, they contract a smaller viral load, which is enabling doctors to treat those patients once they reach an intensive care unit. In ICUs, people are now living, not dying, but we still need the ICUs and we still need the ICU beds in which to treat those people in order that they can live. The fundamental purpose of every measure we take is to protect the NHS and to keep those beds in ICUs, so that they are there to treat people and to keep people alive.
I described this to someone today who argued with me that face masks and coverings are unnecessary. If people are in the space of someone with no facemask—I will use a scale of one to 100—they will breathe in 100 droplets and a full viral load, but when someone has a mask on it is much less. This is not a scientific experiment; it is my own analogy, but the figure is probably 10. The hon. Member for Tooting (Dr Allin-Khan) knows this much better than I do, and can confirm or deny it. Therefore, with a mask, people’s viral load is lower and it is far easier to treat them once they arrive in hospital at A&E and are transferred to an ICU, and there is a huge chance of success. That is what we are seeing in action now in our hospitals. If we all abandon our face coverings, stop social distancing and stop hand washing, we will be back to where we were in March, when the virus was doubling every three to four days.
My hon. Friend the Member for Christchurch (Sir Christopher Chope) mentioned Sweden, but an article in The BMJ—a research study—concluded that Sweden and the US are the only two countries that are failing to reduce their numbers of deaths. In fact, it is far more accurate to compare Sweden with its Nordic neighbours. Sweden has 586 deaths per 1 million people, while its neighbour Norway has 279, so I am not quite sure why Sweden would be cited as a country of success.[Official Report, 24 November 2020, Vol. 684, c. 8MC.]
Ms Dorries
No, there is no time—I am sorry—because I want to go on to what other Members have said.
I want to talk about mental health and just correct a few points, particularly on frontline workers. On the evidence we have at the moment, the two groups of people who are suffering with their mental health as a result of this pandemic are those people who had pre-existing mental health conditions and frontline workers who are suffering from post-traumatic stress disorder. For those frontline workers, a package was put in place straightaway by the NHS, which provided each frontline worker with three counselling sessions, numerous apps and the ability to have a contact and to receive immediate counselling, as well as a website where they could go through the tools used to work through their feelings. Almost every trust manager put in place a support package for frontline workers in their hospitals, and yesterday the NHS announced a further £15 million to support the mental health of frontline workers.
For those with pre-existing mental health conditions—and I would like to pay tribute to Claire Murdoch, who is responsible for mental health delivery in the NHS—trusts across the UK put in place 24-hour mental health crisis helplines in a matter of weeks, and they have had a huge impact. The Government have committed the £2.4 billion; we have accelerated the long-term plan; we have accelerated the trailblazer schemes in schools; we have introduced the wellbeing package in schools for children returning to school, and we have supported the third sector financially to deliver additional mental healthcare to almost every sector of society, including on eating disorders. I always say that is one of the worst mental health conditions because it has a high rate of morbidity, and it too has received additional funding. We have put a huge amount of work into mental health, and I know that Claire Murdoch and others are proud of what the NHS has done in terms of the mental health services that it has delivered.
I cannot answer anybody else, but I will write to people. This has been an important debate in the middle of one the greatest public health emergencies that this country has faced, and I would like to end by again thanking everyone across the country for playing their part to reduce the rate of transmission and to protect their loved ones and our local communities.
Question put and agreed to.
Resolved,
That this House has considered covid-19.